Proving We Can Afford Public Plan Choice

Sen. Max Baucus, D-Mont., has been doing his best to block the most critical element of health care reform—a public health insurance option that can keep private insurers honest. Behind the scenes, progressive groups are preparing to fight back with the proposals that will put to rest the excuse that taxpayers can't afford the substanrial changes we need.

These groups are honing talking points that activists will be able to use next week, when Health Care for America Now and allied organizations will make a major lobbying and grassroots mobilization push against efforts to dilute or eliminate the public plan option from health care reform. One key message: There are reasonable and rational ways to pay for universal health care coverage.

The choice of a public plan option was excluded from the draft bill released Thursday from Baucus' Senate Finance Committee. Bill Scher's Progressive Breakfast column [1] today rounds up the negative reaction from the left. That happened in the wake of a Congressional Budget Office report that fueled scary headlines [2] about the cost of health care reform, even though the report did not factor in a public plan and its potential cost benefits.

The cost debate is forcing to the fore much-needed consideration of changes to our tax structure that will enable us to pay for the health care changes that the country needs. That is a debate Democrats should not fear. Doing nothing already costs the average family covered by health insurance more than $1,000 a year, according to a May 2009 Families USA report [3]. This is a hidden tax that would not be relieved by "reforms" that only make superficial changes but have no meaningful impact on lowering costs.

Instead of forcing families to pay this hidden tax to cover the costs of a dysfunctional and inequitable system, Congress needs to be encouraged to embrace changes that will get that hidden tax off the back of working individuals and families and help pay for making quality health care accessible to everyone.

Some rational and politically viable proposals are on the table to help cover the costs of reform. They include:

• A limit on itemized tax deductions for the wealthiest taxpayers, which could raise more than $260 billion over a decade.
• Extending the Medicare tax to investment income (except for the first $50,000-$100,000 of income for retirees), which could raise an estimated $40 billion.
• Closing corporate loopholes that encourage corporations to shift profits and jobs overseas to avoid U.S. taxes, which can raise $150 billion to $200 billion over 10 years.

These are defensible measures, and progressive groups are honing the arguments that activists can use to make the case to legislators.

The only reason we are not having an honest debate about how to cover the costs and reap the benefits of a public plan is political cowardice on the part of people such as Baucus, whose actions better reflect those of the Senate's chief recipient of campaign cash from the health-care industry [4] than those of a senator representing the interests of voters worrying about how they will pay for health care. The good news is that we are marshaling the arguments that should give other members of the Senate—and we hope ultimately Baucus—enough backbone to stand with us.